LIBERTY UNION HIGH SCHOOL DISTRICT COMMUNITY … · 5. Coordinator of Adult Education (Debbie...

LIBERTY UNION HIGH SCHOOL DISTRICT

COMMUNITY

EDUCATION CENTER

EMERGENCY

PREPAREDNESS PLAN

2017-2018

Approved on 11/08/17 Safety Committee

TABLE OF CONTENTS

SECTION I ....................................................................................................................................................................... 4

SITE DISASTER RESPONSE TEAM ....................................................................................................................... 5

EMERGENCY PROCEDURES .................................................................................................................................. 6

SECTION II ....................................................................................................................................................................12 FIRE AND FIRE DRILL ........................................................................................................................................... 13

BOMB THREAT / BOMB ..........................................................................................................................................14

BOMB THREAT REPORT FORM ..........................................................................................................................16

EXPLOSION / THREAT OF EXPLOSION .............................................................................................................17

SUGGESTED GUIDELINES WHEN DEALING WITH .......................................................................................18

SUICIDE/ DEATH ......................................................................................................................................................18

CHEMICAL INCIDENT ........................................................................................................................................... 19

SEVERE WINDSTORM ............................................................................................................................................20

FLOOD ........................................................................................................................................................................ 20

EARTHQUAKE ..........................................................................................................................................................21

ATTACK / DISTURBANCE BY CRIMINAL OR INSANE PERSON / GROUP / LOCKOUT .........................23

RELEASE OF STUDENTS EVACUATION OF COMMUNITY EDUCATION CENTER ............................... 23

CIVIL DISTURBANCE / LOCKOUT ......................................................................................................................25

FALLEN AIRCRAFT .................................................................................................................................................26

SMOG ALERT ............................................................................................................................................................26

WAR .............................................................................................................................................................................27

SECTION III ...................................................................................................................................................................29 GENERAL PRINCIPLES OF CRISIS INTERVENTION .....................................................................................30

CRISIS INTERVENTION PROCEDURES & RESPONSIBILITIES ...................................................................31

CRISIS CHECK LIST ................................................................................................................................................32

MODEL FOR INTERVIEW OF STUDENTS IN CRISIS ......................................................................................33

STUDENT REFERRAL LIST ...................................................................................................................................35

INITIAL COUNSELING REFERRAL SUMMARY ...............................................................................................36

PARENT CONSENT ..................................................................................................................................................37

EMERGENCY ROSTER ...........................................................................................................................................39

DISASTER PLAN DRILL ..........................................................................................................................................39

EMERGENCY SYSTEMS SHUT-OFF INFORMATION

PG&E meter outside of multi-use room

Need a wrench to shut off ball valve - or in extreme emergency kick meter located behind the Smart

Meter to activate the earthquake shutoff.

Electrical Panel – located outside Adult Ed ladies bathroom

Area consists of 3 metal cabinets. Cabinets are padlocked, and are accessible with Key #2507. To

shut off main power, open the third panel (closes to the door and ladies bathroom) and shut off all 4

panels. If area is hot, do not touch – call 911.

Building Fire Sprinkler system – located in front of main CEC entrance on 2nd St.

This system is independent of the City water main. To shut off the water to the fire sprinklers

inside the building, you must 1) remove padlock and chain with Key #2127 or 2) use bolt cutters to

cut chain and then turn red wheel valve to off position.

City Water Main – located outside of Room 3 on Pine St.

Either of the two valves may be closed using a crescent wrench.

Water Main for buildings located at the back of CEC property (Gateway Program area)

Main is behind unlocked gate. Need wrench to close ball valve.

Extra notes:

1. The maintenance office is padlocked after hours. To open padlock, use Key #2174.

2. Current and previous color coded (Gas, Fire, Electricity, Water) maps provided (1986-

current)

EMERGENCY TELEPHONE NUMBERS

In the event of accident or injury it is important to know what numbers to call: *911 is your main

number. All other numbers are to get additional information after the fact. CALL 911 FIRST.

911 should be called from a landline, if possible, as 911 calls from a cell phone are directed to the

California Highway Patrol.

Fire & Rescue (Paramedics) ...................................................................................................................... 911

Emergency………………………………………………………………………………………925-809-7811

Non-Emergency Police………………………………………………………………………….925-809-7911

Health Department ....................................................................................................................... 925-313-6000

Animal Control ............................................................................................................................ 925-335-8300

Poison Control Center ................................................................................................................. 800-222-1222

Ambulance:

American Medical Response ....................................................................................................... 925-513-3259

Hospitals:

Contra Costa County Hospital ..................................................................................................... 925-370-5000

John Muir Emergency: Walnut Creek ........................................................................................ 925-939-3000

Kaiser Emergency: Antioch ................................................................................................. 925-813-6500

Walnut Creek ........................................................................................ 925-295-4000

Sutter-Delta Medical Center ........................................................................................................ 925-779-7200

Sheriff: Dispatch .......................................................................................................................... 925-646-2441

Brentwood Police: Dispatch ....................................................................................................... 925-809-7811

Brentwood Police: Non-Emergency Dispatch…………………………………………………..925-809-7911

Police:

Antioch - Urgent .......................................................................................................................... 925-778-3911

Brentwood ................................................................................................................................... 925-809-7911

Clayton ........................................................................................................................................ 925-673-7350

Concord ....................................................................................................................................... 925-671-3220

Martinez ....................................................................................................................................... 925-372-3440

Pittsburg ....................................................................................................................................... 925-646-2441

Pleasant Hill ................................................................................................................................. 925-680-7000

Walnut Creek ............................................................................................................................... 925-943-5844

Sheriff’s Office:

Martinez Dispatch ....................................................................................................................... 925-646-2441

Updated 11/2017

1

INTRODUCTION

Goals:

The goal of the Liberty Community Education Emergency Preparedness Plan is to prepare and train

district employees and students to respond properly in emergency situations. This plan hopefully

will provide a foundation to minimize injury and loss of life. Protection of students, employees, and

facilities is of primary importance.

Booklet:

The information contained in the booklet is designed to provide instructions in the event a disaster

strikes this area. The basic plan of action outlines responsibilities necessary to safeguard students

before, during, and after an emergency.

Employee:

Disaster Service Worker

The District will not release students under the age of 19 in an unsafe situation. All public

employees are designated as Disaster Service Workers, subject to service as may be assigned to

them by their supervisors or by law (Gov. Code, Chapter 8, Section 3100). Should a disaster strike

during school hours, no employee will leave his/her assignment under any circumstances unless

officially released by the Superintendent or his designee. In the event of a catastrophic emergency

district employees will remain with students until they can be picked up by parents or guardians. If

parents are prevented from reaching the schools, the District will provide care and shelter until

students and parents can be united. Liberty Alternative Education Center will remain open

indefinitely until every child has been released or transported to an emergency center for proper

care and shelter.

Knowledge Of:

Each staff member needs to be thoroughly familiar with the contents of this emergency action

guide, and students should be instructed in the procedures outlined for emergency action so that

they will be prepared to react quickly to instructions given to them in times of emergency.

2

GENERAL INSTRUCTIONS

A. This plan is designed to prepare you for the impact of a major disaster or emergency

affecting Liberty Community Education Center. These guidelines are general in nature.

They include a quick reference emergency action guide and a list of emergency phone

numbers.

B. Mass panic is one of the greatest dangers. Staff members should remember that in times of

stress they must remain calm, evaluate the situation, and take action based on the best

information available.

C. A well prepared and tested plan for prompt and positive protective actions will minimize

injuries and loss of life in a major disaster. Therefore, all staff members must be thoroughly

familiar with the contents of this plan.

D. In the absence of orders from your supervisor or designee, each staff member is authorized

and directed to implement the actions contained in this plan. Further, each staff member

should take such other action as may be necessary to save lives and mitigate the effects of

the disaster.

E. All recommendations for changes, additions, or deletions to this plan should be forwarded to

the office of the Director of Community Education.

F. Preliminary preparation is as important as knowing survival techniques. Preparation and

understanding will help to eliminate many casualty-causing problems. Knowing where to

go, what to do, and what not to do will help to control a major enemy---PANIC.

3

HOUSEKEEPING

Good housekeeping practices are an essential part of disaster preparedness and can effectively

minimize the effects of a disaster. Poor housekeeping practices can severely compound problems.

1. All heavy objects should be firmly attached to walls.

2. High hook shelves should be secured to the wall.

3. Hazardous substances are to be stored in the manners prescribed by law.

4. Hallways, exits, fire escapes, and doorways must be properly accessible and free from

any form of blockage.

5. No heavy or sharp objects are to be stored on top of high shelves.

All discrepancies should be noted and corrected, work orders submitted and Administration of

Community Education notified for communication purposes with the Maintenance Department.

4

SECTION I

5

COMMUNITY EDUCATION CENTER

SITE DISASTER RESPONSE TEAM

The LUHSD Community Education Center (CEC) Disaster Response Team consists of the

following persons:

1. Director of Community Education (Guy Rognlien, 634-2589, x1016)

2. Assistant Principal of Alternative Education (Ilene Foster, 634-2589, x1061)

3. Supervisor of Maintenance/Operations (Al Wilright, 634-2166, x5792)

4. Director of Facilities (Paul Melloni, 634-2166, x5791)

5. Coordinator of Adult Education (Debbie Norgaard, 634-2589, x1073)

6. CEC Lead / Designated Teachers (634-2589):

IHS Adult Ed Alt. Programs

Anne Banks x1036 Shari Carey, x1050 Jennifer Moody, x1085

Lorraine Maxson, x1151 Cindi Grovhoug, x1046 Megan Render, x1112

Linda Ostermeier, x1091

Rosemary Romeis, x1092

Miriam Drake, x1010

Joy Crum, x1025

Nick Marple, x1045

Paul Lindeman * Designated for Search & Rescue (Assisting Campus Supervisor)

7. Gateway Program Lead Designee (Kristina Jensen)x1131

8. Independence High School (IHS) Secretary (Nicki Pierce)X1023

9. Adult Education Secretary (Brenda Heskett)X1022

10. IHS Registrar (Mary Warr)x1032

11. CEC Secretary (Hermelinda Meraz)X1037

12. School Psychologist (Juanita Scott)X1134

13. CEC Campus Supervisor (Ron Thompson)

14. Adult Education Receptionist (Sara Singrin)X1024

15. CEC Custodians (AM - Jeff Baker, PM- Larry Spiess)

The Command Center is the CEC Director’s office. If it is unsafe:

1. Room 23 (near main parking lot)

2. Parking Lot

3. District Office

6

EMERGENCY PROCEDURES

STAFF DUTIES

General instructions for multiple emergency situations.

Director:

1. Remain Calm.

2. Maintain communication with Disaster Response Team-district level.

3. Determine facility/student safety from Maintenance & Operations.

4. Call for outside assistance.

5. Authorize resumption of power, gas and water services.

6. Authorize return to building. Send verbal or written instruction with available staff.

7. Issue verbal and/or written communiqué to students and staff re: status if emergency period

is prolonged.

8. Debrief meeting with Assistant Principal and Coordinator of Adult Education, teachers and

staff to develop resume of action taken during evacuation regarding medical/trauma,

verification of parental contact of injured persons, facility reports of required repairs.

9. Obtain report of needed facility repairs from the Assistant Principal and or Maintenance &

Operations and notify utility companies of any breaks or suspected break in lines.

10. Determine the advisability of closing the school, with the advice of the Superintendent,

and/or City Building Inspector, if possible.

11. Direct school staff to remain after school hours if required to assist in disaster service

activities.

12. Post guards at a safe distance from all building entrances to see that no one reenters for any

reason until the buildings are declared safe. Guards may be custodians, teachers, or students.

Assistant Principal:

1. Remain calm.

2. Assist the staff in gaining control of the students.

3. Check all areas for damage. Evacuate if necessary.

4. Relay damage reports to control point.

5. Confer with Director of Maintenance and Operations regarding damage status.

6. Initiate search and rescue.

7

7. Medical and trauma reports, names of missing students and their possible location. Go to

designated areas and collect them from staff.

8. Receive and record in writing facility damage reports and confer with Maintenance Control

Point (Custodian Room next to the Outdoor Garden) or by radio.

9. Notify administrator in charge when evacuation has been properly completed.

10. Supervise the duties of the Campus Supervisor and Custodian(s).

11. Verify that an office staff member has notified parents of injured persons.

12. Initiate search and rescue.

13. Coordinate attendance/alarms/telephone/search & rescue/triage/release of students.

14. Relay damage reports to control point.

15. Confer with Supervisor of Maintenance and Operations or Director of Facilities regarding

damage status.

16. Debrief with command center personnel and site district response team.

Coordinator of Adult Education (Triage):

1. Remain calm.

2. Establish and supervise a triage area in Common Grass Area (grass area between Adult Ed

and Gateway)

a. An area for life threatening injuries (e.g. Common Grass Area, room 19-20)

b. An area for minor first aid (e.g. Room 22)

3. Confer with Crisis Team Leader(s) as to the location for psychological trauma and

coordinate psychological first-aid/child care center.

4. Notify the command center as to the location of the triage area, if other than grass area, and

request medical supplies.

5. Supervise the First Aid duties.

6. Have first aid personnel list.

a. Request assistance by first aid trained staff.

7. Accept and record in writing injury reports.

8. Evaluate and communicate injury reports with Assistant Principal (search and rescue).

a. All injured persons should be medically tagged.

b. Supervise the administration of first aid.

9. Coordinate and assist paramedics, firemen, police, and coroner when they arrive at the

Center.

a. Record data on any person moved by ambulance a) Name b) Nature of injury c)

8

destination of ambulance. (Use Check Out form).

b. Instruct Adult Education Secretary to notify parent/family of injured transported

person.

10. Develop resume of action taken re: injured person.

11. Communicate with attendance to account for all students, staff.

12. Disassemble triage area.

13. Inventory remaining first aid supplies.

14. Transport first aid supplies to a central location.

15. Debrief with first aid assistants and with administration.

LUHSD Supervisor of Maintenance and Operations and/or Director of Facilities:

1. Remain calm.

2. Turn off main gas line, and water (if necessary).

3. Turn off main electrical panel.

4. Establish Control Point in Custodian Room next to the Outdoor Garden.

5. Complete facility inspection.

6. Report damage or no damage to Control Point.

7. Receive damage reports from Control Center.

8. Confer with ranking administrator re: status.

9. Assign emergency facility procedures.

10. Assign responsibility for survey of buildings.

11. Assign check of facilities reported by staff as damaged.

12. Confer with ranking administrator re: next actions.

13. Assign damage control tasks.

14. Direct fire-fighting efforts until regular fire-fighting personnel take over.

15. Certify building safety and restore services and confer and debrief with ranking

administrator re: next actions.

9

Administration Designees: (IHS Counselor, Gateway Transition Specialist)

1. Remain calm.

2. Establish, manage and operate the Command Center- 1) Director’s Office

2) Room 23 3) Parking Lot 4) District Office.

3. Supervise the duties of the secretarial and paraprofessional staff.

4. Receive and record in writing reports regarding attendance with regard to students and staff

(all IHS students sign in and sign out with their primary teacher whenever they are on

campus); medical and trauma reports; names of missing students.

5. Communicate the possible location of missing staff and students to the Assistant Principal

and or Director.

6. Verify that parents of injured persons have been notified.

7. Coordinate attendance/alarms/telephone/search & rescue/triage/release of students/psych

first-aid with Administration.

8. Confer and relay damage status Assistant Principal for coordination with Maintenance and

Operations.

9. Debrief with communication center personnel and site district response team.

Independence High School Secretary:

1. Remain calm.

2. Assist the staff in gaining control of the students and the collection of attendance. Send the

attendance sheets to the Command Center.

3. Take cell phone and radios to Command Center.

4. Supervise the release of personnel if it is necessary to release students to parents/guardians.

Check for parent, teacher and student signatures before permitting a student to depart the

grounds.

5. Coordinate assistance of other support staff such as the CEC Secretary, and Para-

professionals (this includes the Gateway Designee or Office Paraprofessional).

Adult Education Secretary and/or Gateway Office Paraprofessional:

1. Remain calm.

2. Coordinate timely notification to parents.

3. Accept and record calls from parents.

4. Call parents of students who have been transported by ambulance. Maintain a list of

transported students and advise release personnel.

5. Pull emergency cards for students on injury list.

10

6. Notify the parents/guardian of any injured student; inform of status.

7. Receive and record in writing any emotional trauma reports. Notify Crisis Team Leader(s)

or appropriate staff member to remain with the individual.

8. Record new messages for the telephone system.

Adult Education Receptionist/ IHS Registrar (Physical First-aid):

1. Remain calm.

2. Maintain a first-aid kit (in front office supply room) and bull horn in the Director’s office.

3. Maintain a list of staff who are first-aid and/or CPR certified.

4. Accept and record in writing all injury/trauma reports.

5. Evaluate injury reports.

6. Assist in making sure materials are transported to the triage area if necessary.

CEC Secretary and/or Psychologist (Psychological First-aid) – Crisis Leader(s):

1. Remain calm.

2. Report to the receptionist for psychological trauma reports.

3. Assist students and staff in returning to normal routines as quickly and calmly as possible

following a major disruption to the educational process.

4. Coordinate with triage (Coordinator of Adult Ed) for location for psychological first aid.

CEC Campus Supervisor/*Designated Teachers:

1. Remain calm.

2. Under direction of the Assistant Principal, dispatch search teams to assigned areas; search

should be done visually, verbally, and physically.

3. Check all classrooms, closets, offices, storage rooms, bathrooms, etc., Check off each area

after it has been searched.

4. Remove injured persons and take only lifesaving first aid measures; otherwise have patient

transported to the designated triage area.

5. If fatalities have occurred and bodies are moved, note the location and condition of bodies

on a triage tag for future reference by the coroner.

6. Secure all buildings from reentry after search.

7. While sweeping the entire site, note dangerous or pending problems and any obvious

building damage on a damage assessment form.

11

8. When primary search is completed report to the receptionist/registrar and complete

injury/trauma reports. Proceed with secondary search for unaccounted student/staff.

9. Rope off unsafe areas.

10. For heavy rescue of trapped victims that is beyond the capabilities of staff and equipment at

school site, contact an administrator to request whatever resources you will need to

accomplish the rescue.

11. Proceed with secondary search and/or assist in the triage area.

Custodians

1. Remain calm.

2. Get direction from ranking administrator re: next actions.

3. Assist Campus Supervisor in search and rescue or facility checks.

12

SECTION II

13

Community Education Center

EMERGENCY PROCEDURES

FIRE AND FIRE DRILL

Warning Signal/Announcement (Repeated at least two times):

Alarm and/or “Attention Staff and Students – this is NOT a drill. Evacuate the buildings

immediately. Proceed in an orderly manner to your designated evacuation area. Students, remain

with your teacher. Remain calm. Listen for further instructions.”

Immediate Action: If fire present, pull nearest alarm. Evacuate the building.

OR


Alarm and/or “Attention Staff and Students – this is a drill. Evacuate the buildings immediately.

Proceed in an orderly manner to your designated evacuation area. Students, remain with your

teacher. Remain calm. Listen for further instructions.”

Immediate Action: Evacuate buildings.

All Clear Signal/Announcement (Repeated at least two times): “Attention Staff and Students – ALL CLEAR (pause). ALL CLEAR (pause). ALL CLEAR

(pause). It is now OK to resume normal school activities.”

Procedure

Teacher Action:

1. Remain calm. Do not alarm students.

2. Direct students to follow directions of all school personnel and immediately move in silence

to grass area or alternative directions as issued by Director or designee in the event that the

fire is outside.

3. Make certain every student has left the building. In the event that a person has been injured

and you are not able to evacuate someone, mark the building area (door window) with a Red

Card (or X). This will alert Search and Rescue that there is someone inside the building.

4. Note the name of any injured person, nature of injury, the location of the person.

5. Upon reaching the grass area, immediately take attendance and hold up Green (all accounted

for) or Red (missing student/staff) Cards. Attendance sheets will be collected by the

Independence High School Secretary.

6. Render first aid as necessary.

7. Students and staff should not return to the school until authorized school officials declare

that the school is safe.

14

BOMB THREAT / BOMB

When receiving a bomb threat, it is important that you remain calm. The person receiving the

threat must use the Bomb Threat Form and follow the scripted questions, keeping the caller on

the line as long as possible. (If in person, immediately call Administration). Copies of this form are

to be kept by the telephones in each room and office.

Person Receiving the Threat: Contact Administration/Superintendent and call 911 to report the

threat.

If Determined to be a Legitimate Threat:

Depending whether the threat is inside or outside, an Evacuation or Reverse Evacuation (direct all

inside) will be implemented.

Evacuation Warning

Signal/Announcement (Repeated at least two times):




Immediate Action: Evacuate the building.

OR

Shelter in Place/Reverse Evacuation Warning


“Attention Staff and Students – this is a NOT a drill. We are instituting a Shelter in Place and a

Reverse Evacuation for all persons outside. Students, remain with your teacher. Remain calm.

Listen for further instructions.”

Immediate Action: Duck, Cover and Hold. Reverse Evacuation and Duck, Cover and Hold inside.



Procedure

Evacuation - Teacher Action:

1. Remain calm.

2. Cover nose and mouth with a cloth if possible to reduce breathing in anything harmful.

3. Caution all against picking up any strange objects.

4. Stay with students and remain clear of buildings and trash cans.

5. Upon reaching the grass area, immediately take attendance and hold up Green (all accounted

for) or Red (missing student/staff) Cards. Attendance sheets will be collected by the

Independence High School Secretary.

6. Students and staff should not return to the school until authorized school officials declare

that the school is safe.

15

Shelter in Place/Reverse Evacuation -

1. Remain calm.


3. Caution all against picking up any strange objects.

4. Get inside and give Duck, Cover and Hold command.

5. Wait for further instructions and be prepared for possible evacuation.

16

COMMUNITY EDUCATION CENTER

929 Second Street

Brentwood, CA 94513

925-634-2589

BOMB THREAT REPORT FORM

TIME___________________________________________DATE __________________________

HOW REPORTED_____________________________________ Extension ___________________

EXACT WORDS OF CALLER:

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

Questions to ask:

1. ________ When is the bomb going off? ___________________________________________

2. ________ Where is the bomb to explode? __________________________________________

3. ________ Where is the bomb right now? __________________________________________

4. ________ What kind of bomb is it? _______________________________________________

5. ________ What does it look like? ________________________________________________

6. ________ Why did you place the bomb? ___________________________________________

Description of caller’s voice: Male_______ Female_______ Young _______ Middle Aged_______ Old_______

Ethnic type?______________ Accent _______________What kind? ___________

Tone of voice:

Serious________ Joking _________ Giggling or laughing ________ Sounded tense________

Sounded very sure________ Sounded unsure________ is voice familiar? __________

If so, whose? _________________________________

Were there any background noises? _____________________________________

Other voice characteristics _____________________________________________

Time caller hung up ______________________________ Action taken ______________________

Name, title, address, telephone number of recipient: ______________________________________

________________________________________________________________________________

________________________________________________________________________________

Action taken by recipient: __________________________________________________________

Signature: ________________________________ ________________________________

Recipient Director

17

EXPLOSION / THREAT OF EXPLOSION

Evacuation Warning





Immediate Action: Evacuate

OR

Shelter in Place Warning

Signal/Announcement – (Repeated at least two times):

“Attention Staff and Students – this is NOT a drill. Shelter in Place. Students, remain with your


Immediate Action: Duck, Cover and Hold

All Clear Signal/Announcement (Repeated at least two times): “Attention Staff and Students – ALL CLEAR (pause).ALL CLEAR (pause). ALL CLEAR (pause).

It is now OK to resume normal school activities.”

Procedure

Explosion - Teacher Action:

1. Remain calm.

2. Give Duck, Cover and Hold command.


4. If the explosion occurred within the building or threatened the building, the teachers should

immediately implement action to evacuate the building.

5. Set off Site alarm for “Panic” on Security System located in front office. Hold Ready and #

key or pull fire alarm located in hallways.

6. Make certain every student has left the building. In the event that a person has been injured

and you are not able to evacuate someone, mark the building area (door window) with a Red

Card (or X). This will alert Search and Rescue that there is someone inside the building.

7. Move to an area of safety (grass area if possible) and maintain control of students. Caution

students to stay clear of building and trash cans.


9. Notify Director or designee, call 911. 911 calls should be made from a landline, if possible.

10. Fight incipient fires without endangering life.

11. Take attendance and use Green or Red Card for visual communication.

18

12. Attendance Sheets will be collected by Independence High School Secretary.

13. Students and staff should not return to the Site until the fire department or administration

declare the area safe.

14. Notify utility companies of a break or suspected break.

15. Students and staff should not leave area until authorized school officials declare that the

school is safe.

Threat of Explosion - Teacher Action:

1. Evacuate the building. Do not sound school fire alarm if gas fumes are present.

2. Follow directions under Explosion above.

*Teachers should instruct students to react in the same manner on their own to this type of

catastrophe in case it occurs while they are on their way to or from school.

SUGGESTED GUIDELINES WHEN DEALING WITH

SUICIDE/ DEATH

ON CAMPUS

If a suicide or sudden death of either a student or staff member occurs, the following guidelines will

apply:

Communication:

1. Remain calm.

2. Administrative staff will be assembled to plan and implement an Action Plan.

3. All requests for information will be directed to the Director’s Office.

Suggested Action Plan for Staff:

1. Remain calm.

2. The Director initiates a chain call to all faculty to inform them of the tragedy.

3. The Director meets with the staff to provide known facts relating to the incident and to plan

activities for the day.

Suggestions for Dealing with Students:

1. Remain calm.

2. Give students all of the known facts.

3. Allow students to discuss feelings of loss.

4. Encourage students to discuss their good and bad memories of the person without penalty.

5. Students must be able to participate in discussions of depression, death, and suicide.

6. Students who are close to the victim should be identified and monitored.

7. Allow students to bring flowers to place on the desk of the student or teacher.

8. Allow students to write grievance cards, poems, and letters to surviving relatives.

9. Allow students to attend eulogy service/funeral.

19

Suggestions for Dealing with Parents:

1. Remain calm.

2. Make facts available through special PTA meeting, school to home newsletters, etc.

3. Assign a staff person to be a resource providing information/channel of communication, as

needed.

CHEMICAL INCIDENT


“Attention Staff and Students – this is NOT a drill. A potentially dangerous chemical release has

occurred. We are instituting a shelter in place. Persons outside should move immediately indoors.

Remain in your classroom until further notice. Close all windows, doors and turn off any or all fans

or blowers. Do not, I repeat, do not change classes or leave your area until further notice. Listen for

further instructions. This Signal/Announcement will be repeated every two minutes until the

campus has been given the All Clear”.

Immediate Action: Shelter in Place and remain indoors.



Procedure

Teacher Action:

Either keep students in your location or assist in moving them to a safe area to clear the building.

Please do not use the telephone unless you have an emergency. In the event that students need to be

evacuated, directions will be given by administration.

1. Always move crosswind - never up or down wind to avoid fumes.

2. Maintain control of students.




6. After the school has been evacuated do not return to school until the fire department declares

the area safe.

20

FLOOD


“Attention Staff and Students – this is NOT a drill. We have a report of flooding in/around our site

and we are instituting a Shelter in Place and STAND BY directive. Students, remain with your


Immediate Action: Shelter in Place and Stand By

All Clear Signal/Announcement (Repeated at least two times): “Attention Staff and Students – ALL CLEAR (pause). ALL CLEAR (pause). ALL CLEAR (pause).


Procedure

Teacher Action:

1. Remain Calm.

2. Listen for further instructions regarding possible evacuation (if indoor flooding).

3. Students and staff should not leave area until authorized school officials declare that it is

safe to do so.

SEVERE WINDSTORM


“Attention Staff and Students – this is NOT a drill. Persons outside should move immediately

indoors. Remain in your classroom until further notice. Students, remain with your teacher.

Remain calm. Listen for further instructions.”

Immediate Action: Duck, Cover and Hold. Direct all inside.

All Clear Announcement (Repeated at least two times): “Attention Staff and Students – ALL CLEAR (pause). ALL CLEAR (pause). ALL CLEAR (pause).


Procedure

Teacher Action:

1. Remain calm.

2. Direct all students/staff to go inside the building.

3. Close windows and doors.

4. Remain near an inside wall on the floor if possible. (In the hallway, away from doors)

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5. Evacuate areas bearing full force of wind.


7. Take attendance again if you leave your location to seek shelter in a safer place.


9. Keep tuned to a local radio station for latest advisory information.

10. Notify utility companies of any break or suspected break.

EARTHQUAKE


“Attention Staff and Students – this is NOT a drill. We are experiencing seismic activity. For your

protection, following Duck, Cover and Hold on procedures. Repeat: Duck, Cover and Hold.

Remain calm. Listen for further instructions.”

Immediate Action: Duck, Cover and Hold.



Earthquake drills are required by state law

Drill Signal / Announcement (Repeated at least two times):

“Attention Staff and Students – this is an earthquake drill. Repeat: Duck, Cover and Hold. Remain

calm. Listen for further instructions.”

Immediate Action: Duck, Cover and Hold.



Procedure

Teacher Action While Indoors At School:

1. Give Duck, Cover and Hold Command

A. Remain Calm.

B. Get under equipment where available. Otherwise get next to an inside wall or under

an inside doorway.

C. Drop to knees with back to the windows and knees together.

D. Clasp both hands firmly behind the head, covering the neck.

E. Bury face in arms, protecting the head. Close the eyes tightly.

F. Stay there until subsequent instructions are given. Such instructions will depend

upon circumstances and the extent of damage to the buildings.

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G. As soon as possible, teachers shall move students away from windows and out from

under heavy light fixtures (cubicles if possible).

2. Assess any injuries to students and damage to the building. If it appears safe do not evacuate

the area until instructions are given which relate a safe route to the grass area.

A. Remain Calm.

B. Gain control of the students.

C. Note the name of any injured person, nature of injury, the location of the person.

D. Take attendance and use Green or Red Card for visual communication.

E. Attendance Sheets will be collected by Independence High School Secretary.

F. Render first aid if necessary.

3. Evacuate the building and move a safe distance away from it, preferably the grass area. Gain

control of students. Select a safe route based on power line, gas main, and water main and

building failure and proceed to the grass area. Admonish students not to touch electrical

wires and avoid the lighting of any burners or stoves until the area is declared safe.

A. Remain calm.

B. In the event that a person has been injured and you are not able to evacuate someone,

mark your door with the RED Card (or X). This card will alert Search and Rescue

that there is someone inside the room.

C. Note the name of any injured person, nature of injury, the location of the person.

D. Take teacher schedule book from the Secretary of Independence High School (on

desk) and evacuate. Direct the students to stay together and move in silence to the

assigned assembly area in the grass area. The teacher must determine the route to the

grass area if the normal route is not safe.

E. Take attendance and use Green or Red Card for visual communication.

F. Attendance Sheets will be collected by Independence High School Secretary.

G. Render first aid if necessary.

*Teachers on a prep period should initially report to the grass area until further notice.

During Non-Classroom Times:

1. Everyone is to implement Duck, Cover and Hold.

2. When shock ceases, move to the area at a safe distance from buildings then move to the

grass area.

3. Teachers/Designees note the name of any injured person, nature of injury, the location of the

person.

4. Take attendance of all present.



7. Render first aid if necessary.

23

8. Students and staff should not leave area until authorized school officials declare that the

school is safe.

Procedures for Releasing Students:

No student under age 19 will be released without a written release form with the signature of a

parent/guardian. The teacher must sign the release form and the student must sign the release form.

The release form must be turned in for the student to leave. This form will be retained by the school.

18 Year Old Students may sign their own release form if they have an “emancipation letter” on file

(This does NOT apply to Gateway Program students).

COMMUNITY EDUCATION CENTER EVACUATION



3. Teachers are to remain with their student(s) at the grass area. No student under the age of 18

will be allowed to leave unless a parent/guardian/person named on the emergency card comes to

the grass area and signs for the release of the student.

4. The student will be called for by the Independence High School Office. The dismissed student

will evacuate the grass area behind the Community Education Center. The Adult Education

secretary will have the names of students who have been released. The student will sign out

before allowed to leave.

ATTACK / DISTURBANCE BY CRIMINAL OR INSANE PERSON / GROUP / LOCKOUT

In the event that such an occurrence happens outside the Community Education Center, contact the

Director or designee immediately.


“Attention Staff and Students – this is NOT a drill. We have an emergency situation and must

implement LOCKOUT procedures. All persons should go to the nearest classroom. Teachers,

close and lock your classroom doors, cover windows if possible. All students and staff are to

remain in the locked classroom until further notice. DO NOT post any Green or Red Cards on the

doors or windows. DO NOT leave the classroom. DO NOT open or unlock the door until you are

directed to do so by an administrator or law enforcement. Remain calm. Listen for further

instructions.”

Immediate Action: Lockout, Duck, Cover and Hold. Call if for assistance if you are in direct

contact with person(s).


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Procedure

Teacher Action indoors:

1. Give Duck, Cover and Hold command.

2. Remain calm.

3. Gain control of the students and try and get to cubicles and stay down until subsequent

instructions are issued.

4. Remain quiet.

5. Lock or barricade all doors.

6. Close drapes, curtain and cover glass in the door. (DO NOT place RED/Green Cards or X)

7. Wait for further instructions.

8. Note in writing the name(s) of injured person(s), nature of injury, the location of the person.

9. Render first aid as needed.

Teacher Action if occurs outside:

1. Remain still until circumstances permit movement, then proceed to the office or report to the

Director/designee or police officer for directions.

Teacher Action - In the event of a HOSTAGE SITUATION:

1. Gain control of students, remain calm, and avoid startling noises, antagonizing or

challenging the intruder.

2. Cooperate with the intruder and follow their instructions if possible.

Command Center (Director’s Office) Action:

1. Give Duck, Cover and Hold command

2. Remain calm.

3. Call for outside assistance

4. Make available all medical supplies.

5. Maintain communication with the Disaster Response Team - District Office.

6. Prepare to receive and record attendance, injury and damage reports.

Receive and Organize Reports:

1. Accept and record in writing injury, damage, and attendance reports.

2. Evaluate injury reports. Send assistance when possible.

3. Pull emergency cards and current demographic information for any injured person.

4. Accept and record in writing telephone calls from parents. Inform parents not to

come to school site.

5. Record in writing data for any person administered first aid or transported.

6. Include a) name, b) nature of injury, c) destination of ambulance, d) time of

departure.

7. Call parents of injured students and inform them of status.

Recovery:

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1. Determine facility safety with assistance of police and/or fire chief

2. Evacuate if necessary.

3. Convene Crisis Intervention Team.

CIVIL DISTURBANCE / LOCKOUT

In the event of a civil disturbance, the Director or designee will immediately notify the

Police/Sheriff’s Department at 911.


“Attention Staff and Students – this is NOT a drill. We have a situation and must implement

LOCKOUT procedures. All persons should go to the nearest classroom. Teachers, close and lock

your classroom doors. All students and staff are to remain in the locked classroom until further

notice. Do not open or unlock the door until you are directed to do so by an administrator or law

enforcement. Remain calm. Listen for further instructions.”

Immediate Action: Lockout. Remain inside your area.



Procedure

Teacher Action:

1. Under the direction of the Director or designee, available staff members will assist in

confining the disturbance to one area.

2. Teachers will keep students in their location until notified that the disturbance has been

controlled.

3. Teachers who do not have a student will report to the Independence High School Secretary

for assignment to specific duties.

4. In extreme situations, the Director or designee will address the group, informing participants

of possible consequences of their actions.

a. Individuals who violate school policy by encouraging illegal demonstrations by

fellow students may be immediately suspended.

b. Individuals who refuse to comply with school and civil regulations will, if necessary,

be removed from the school premises by the police.

c. Participants in illegal demonstrations will be ordered to cease such activity and

remove themselves from the area. Those remaining after a reasonable period of time

may be subject to suspension from school.

d. Leaders of illegal demonstrations, either active in addressing the group or restraining

the voluntary actions of any individual who wishes to return to class, should be

addressed by name and told that should he/she persist in these actions, he/she may

immediately be suspended from school.

e. Students who are on the fringes of the demonstration (onlookers) who do not honor

the order to disperse, may be suspended from school and removed from the school

property by the police.

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5. In the event the disturbance is serious enough to require police assistance in controlling the

environment, it must be understood that authority for decision-making then becomes a

police matter.

FALLEN AIRCRAFT


“Attention Staff and Students – this is NOT a drill. We have a situation and must institute a STAND

BY and shelter in place.”

Immediate Action: The Director or designee will determine which action, if any, should be

implemented.



Procedure

Teacher Action:

1. Where necessary, teachers will take immediate action for the safety of students without

waiting for directions.

2. All students and staff will be kept at a safe distance.

3. Wait for further instruction from administration.

SMOG ALERT

The District will be notified of a smog alert by Air Quality Management District.


“Attention Staff and Students – this is NOT a drill. This District has notified us that we are in a

“Third Stage SMOG Alert”, students and staff members should remain indoors and restrict

movement as much as possible.”

Immediate Action: Turn off all blowers and fans and monitor students for respiratory distress.



Procedure

Teacher Action:

1. Remain calm.

2. Observe students and staff for respiratory distress.

3. Report any problems to the Independence High School Office.

4. Remain in shelter unless directed otherwise by administration.

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WAR


“Attention Staff and Students – this is NOT a drill. A warning has been received from the Civil

Defense Warning System. An attack is in progress against the United States, its territories,

possessions, or allies. This is a (Strategic, Attack or Surprise Attack Warning).”

Immediate Action: Immediately move to a safe place. Duck, Cover, and Hold. Wait for further

directions from the Superintendent’s Office.



Procedure

“STRATEGIC WARNING”: This is a notification that enemy-initiated hostilities may be

imminent. Dissemination will be by news media. No estimate can be made of the duration of a

strategic warning condition. The warning time may vary from several hours to several days.

School Action:

1. Remain calm.

2. Upon direction of the Superintendent implement action to send students home.

3. Notify the office of the Superintendent when this has been accomplished.

“ATTACK WARNING”: This is a notification that enemy-initiated hostilities is in progress.

Dissemination will be by news media and Superintendent’s Office.

Teacher Action:

1. Remain calm.

2. Give the Duck, Cover and Hold command.

3. Turn on a battery-operated A.M. radio and tune to any EBS station for official information

and instructions.

4. Take precautions to minimize the possibility of persons being struck by flying objects such

as glass and/or blinds.





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10. In the event that you are instructed to evacuate, and a person has been injured but are not

able to evacuate them, mark your door with the Red Card or X. This card will alert Search

and Rescue that there is someone inside the room.

“SURPRISE ATTACK WARNING”: Detonation of a weapon will be the only notification. This

will be accompanied by extreme intense light and heat. The light is followed by heavy shock (blast)

waves.

Teacher Actions:

1. Give the Duck, Cover and Hold command.

2. When blast wave has passed, command action to take shelter inside if one is not already in a

sheltered area.






8. In the event that you are instructed to evacuate, and a person has been injured but are not

able to evacuate them, mark your door with the Red Card or X. This card will alert Search

and Rescue that there is someone inside the room.

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SECTION III

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GENERAL PRINCIPLES OF CRISIS INTERVENTION

Adapted from “Crisis Counseling: Conceptualizations and General Principles,”

Jonathan Sandoval, School Psychology Review, 1985, Vol. 14, No. 3

1. Intervene Immediately - Be Direct, Active, Authoritative

The sooner the student is assisted in coping with the crisis situation, the better the chances of

restoring equilibrium. The longer the student remains in a state of confusion, unable to take some

sort of action to address the situation, the more difficult it will be to intervene.

2. Keep the Focus of the Intervention on the Precipitating Situation

Help the student to accept that the crisis situation has occurred by encouraging the student to

express the facts of the situation as well as expressing feelings. Don’t let defense mechanisms such

as denial operate and prolong the crisis situation.

3. Provide Accurate Information about the Situation

Give a realistic orientation about what has occurred and what might be the expected outcomes.

4. Do Not Give False Assurance. Always Remain Truthful and Realistic

Recognize the anxiety, depression or tension, but at the same time provide some sense of hope and

expectation that the person will ultimately overcome the crisis. However, let the student know that

things may never be the same as they were before the crisis.

5. Recognize the Primacy of Taking Action

Every crisis counseling interview should have an ultimate outcome of some action that the

individual is able to take. Restoring the person to the position of actor rather than victim is critical

to success.

6. Provide Emotional Support for the Individual

Find a group of peers, school staff members or family members that can provide both support and

temporary assistance during the crisis. Implement a buddy system so that the student isn’t left alone.

7. Focus on Self-Concept

Emphasize how the person did cope with the situation so far and how the person has already begun

to use strategies for moving forward. Encourage the individual to implement solutions or strategies

which have a high probability of success.

8. Encourage Self-Reliance

Provide constructive activities that the person can do to assist with the situation, such as helping to

straighten up the classroom, preparing materials to share with classmates. Reinforce whatever

problem solving the individual has demonstrated to this point in time.

9. Be Concerned and Competent

The more adults can present themselves as a model of a competent, problem solving individual and

demonstrate the process of taking in information, choosing between alternatives, and taking action,

the more children will be able to function adequately. Therefore, it is important that staff members

establish their own support systems so that they can adequately cope with the situation.

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CRISIS INTERVENTION PROCEDURES & RESPONSIBILITIES

Crisis intervention deals with normal people in unusual situations who may respond in various

psychological ways. It is important that during the immediate hours and days which follow a

disaster children and staff are helped to return to emotional equilibrium.

Director or Designee

1. Determine if your staff can handle the situation or if outside assistance is needed. Make the

contact requesting outside assistance.

2. Inform staff, students, and district office of factual information.

3. Convene the staff and meet outside persons as they arrive.

Independence High School Secretary

1. Receive telephone calls.

2. Record parent name and telephone number.

3. Instruct parents not to come to school unless requested to pick up their student.

4. Release no information relating to the situation. Refer all information requests to the district

office.

5. Establish a sign-in and message center for outside assistance person(s).

6. Maintain Intervention team folders for the outside assistance person(s).

7. Assist the staff.

Staff

1. Assess the situation.

2. Identify at risk students or staff.

3. Assign conference areas for individual and group consultations.

4. Coordinate efforts with outside assistance.

5. Debriefing and reassessment of the situation.

Outside Assistance Person(s)

1. Register with the Independence High School Office/Secretary, procure ID and intervention

folder which contains the following information:

a. Accountability procedures/forms

1) Attendance Accounting

2) Student Referral Form

3) Initial Counseling Referral Summary

4) Parent Consent Form

b. General Principles of Crisis Intervention

c. Model For Interview of Students in Crisis

d. Suggested Guidelines for the Management of the Aftermath of a Suicide or

Sudden Death at School.

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CRISIS CHECK LIST

SCHOOL DISASTER TEAM INITIAL CRISIS SCREENING

______ A. Identify problem/event and determine degree of impact on the school.

______ B. Determine if additional support is needed. Director may request outside

assistance.

______ C. Review facts and determine what information is to be shared with:

_______ 1) Staff

_______ 2) Students

_______ 3) District

Determine how the information is to be shared with staff, students and district.

_______ 1) Written bulletins

_______ 2) Verbal communication/discussions

_______ D. Initiate the referral process, including procedures for self-referral

_______ 1) Provide Referral forms to Staff

_______ 2) Maintain student Referral list. Designate

where list will be maintained and by whom.

_______ 3) Designate interview locations

_______ 4) Distribute Initial Referral Summary and

Screening Survey and Parent Consent forms

to Interview

_______ E. Establish a reception center for support service personnel.

_______ F. Identify high risk students. Initiate contacts and appropriate interventions.

_______ G. Interventions

_______ 1) Individual Interviews

_______ 2) Group counseling

_______ 3) Parent meetings

_______ 4) Staff meeting

_______ 5) Referrals to community agencies

_______ H. Debriefing – on a daily basis

_______ 1) Review process, status of referred students

_______ 2) Prioritize needs

_______ 3) Plan follow-up actions

_______ 4) Provide support to team members

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MODEL FOR INTERVIEW OF STUDENTS IN CRISIS

The following two techniques for interviewing students who have been subjected to trauma or crisis

have been adapted from Golan’s and Pynoos’ work:

Children have different skills for dealing with information and reacting to events depending on their

age and development level. Counseling with younger children requires involvement and use of

nonverbal material and very directive ways to elicit and reflect feelings. Frequently facts and

fantasy are intermingled and young children have difficulty acknowledging a crisis. With

adolescents however, a discussion format can be possible as a means to focus on problem solving

and crisis-coping skills.

One then may want to select one of the two initial interview techniques as it fits the student as well

as the crisis impact.

Golan’s model interview is a three stage model. The stages are: Immediate Focus of Crisis

Situation, Evaluation of Current Predicament, and Development of Contract for Further Activity.

Pynoos’ model interview proceeds from drawing and storytelling to discussion of the actual

traumatic situation to the consequences of the crisis for the child. It is also a three phase process

with the three phases being: Opening, Trauma, and Closure.

The goal of the interview is not just to identify the immediate effects of the trauma, but also to assist

the child in mastery of the traumatic experience.

The following is a description of the GOLAN Model:

A. Immediate Focus on Crisis Situation

1. Establish rapport.

2. Identify the precipitating event. Try to get as many details and facts as possible.

(Keep in mind that it is not the exact accuracy but the actual telling that is important

here.)

Information to be obtained:

What is threatening to the client?

What is new to the client in this particular crisis?

What is the immediate problem - as distinguished from chronic

problem?

3. Elicit subjective reactions to the event.

Try to get affective responses.

Tell the student that it is okay to cry.

(The goal is to bring out reactions to the current situation.)

Information to be obtained:

In what way does this particular situation differ from other similar

situations?

Who are the significant persons related to the crisis?

How are such persons involved?

How much guilt, responsibility, anger, fear is there?

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4. Investigate recent losses, threats, challenges. Use verbal or image provoking

activities such as drawings, play activities or story writing to bring these to the

surface. Try to get affective responses as well as facts and details. (Remember that

past experiences have impact on the current crisis.)

5. Assess the nature and duration of the vulnerable state. Investigate previous problem

solving patterns and coping skills and the extent to which they are still working or

not working. Try to bring out what did and did not work. Evaluate the present

situation, especially the state of active crisis. See if changes are still taking place.

6. Determine availability of support systems and resources.

B. Evaluation of Current Predicament

1. Based on the assessment of the dynamics of the situation state the problem to the

student, including the basis of the conflict. (Phrase in terms of the dilemma with

which you see the student is at.)

2. Ask the student how he/she sees the situation and what is seen as the most pressing

problem.

3. Together settle on a target problem. This can be viewed as cutting the problem down

to size or confronting the crisis situation in manageable bits.

C. Development of Contract for Further Activity

1. Facilitate the exploration of novel approaches to the problem and consider old

approaches that were practiced.

2. Set up a working plan of what the student will do, what others will contribute.

3. Be as specific and concrete as possible.

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FAR EAST COUNTY INTER-DISTRICT

CRISIS INTERVENTION TEAM

STUDENT REFERRAL LIST

SCHOOL: ___________________________

DATE NAME OF

STUDENT

TIME

IN/OUT

SYMPTOMS ACTION

TAKEN

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INITIAL COUNSELING REFERRAL SUMMARY

Date_________________

Name of Student _____________________________Teacher ___________________________

Referred by Whom? ___________________________ Room ____________________________

REASON FOR REFERRAL

(List somatic, emotional reactions)

SUMMARY/COMMENTS:

IMPRESSIONS:

Students’ Area of Need: ______________________________________________________

Parent’s Area of Need: _______________________________________________________

Student has been referred to (Mental Health, School Psychologist Follow-up, etc.)

__________________________________________________________________________

__________________________________________________________________________

Student Seen By ______________________________ Parent Consent Obtained?

Date ________________ Yes_________ No_________

PLEASE RETURN FORM TO SCHOOL PSYCHOLOGIST AT END OF SESSION

Far East County Inter-District Assessment Center

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PARENT CONSENT

Date _______________________

I hereby grant permission for my son/daughter (circle one) _______________________________

to be provided psychological counseling. First & Last Name

The extent and limitation of my rights as a parent have been explained to me by

______________________________________________________ on _________________

Name and Title Date

I understand that I may revoke my consent in writing at any time.

_______________________________________________________________________________

Name Relationship

The completed form shall be filed and maintained within the student’s permanent record

folder.

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EMERGENCY ROSTER SHEET TEACHER NAME CLASS PERIOD/TIME

TOTAL # IN CLASS WHEN ALL ARE PRESENT ROOM #

TOTAL # ACCOUNTED FOR IN EVACUATION AREA.

A. ATTENDANCE/ABSENCES Name and/or Student I.D. Number of students absent from your class today.

1. 4. 7.

2. 5. 8.

3. 6. 9.

B. UNVERIFIED STUDENTS/STAFF Name of student/staff NOT accounted for. (These students/staff were with you at the time roll was taken and are

not in the evacuation area with your group.)

1. 4. 7.

2. 5. 8.

3. 6. 9.

C. STUDENTS PRESENT; NOT ON CLASS ROSTER Name and/or Student I.D. Number of students not on your attendance sheet but are with you this period.

1. 6. 11.

2. 7. 12.

3. 8. 13..

4. 9. 14.

5. 10. 15.

D. INJURED Name Possible Location

For additional comments use back of form.

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LIBERTY UNION HIGH SCHOOL DISTRICT

DISASTER PLAN DRILL

Please use this Disaster Drill Record form to record information regarding your drill. Keep a copy at

your site and forward a copy to the Director of Administrative Services.

School Site: ____________________________ Type of Drill: _________________________

Administrator in Charge: ________________________________ School Year: ______________

Disaster Drills

Month

Day

Time

# Evacuated

IF

APPLICABLE

Second to

Evacuated

If Applicable

Alarm

Station

If

Applicable

Person

in

Charge

JANUARY

FEBRUARY

MARCH

APRIL

MAY

JUNE

JULY

AUGUST

SEPTEMBER

OCTOBER

NOVEMBER

DECEMBER

Fire and Earthquake Drills are required at least once each semester.

A record shall be kept in the Principal’s Office of date and hour of each drill and made available

upon inspection.

Summary of Drill:

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

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